Long-term outcomes of endoscopic submucosal dissection for high-grade dysplasia and early-stage carcinoma in the colorectum  

作　　者：Tao Chen Wen-Zheng Qin Li-Qing Yao Yun-Shi Zhong Yi-Qun Zhang Wei-Feng Chen Jian-Wei Hu Marie Ooi Ling-Li Chen Ying-Yong Hou Mei-Dong Xu Ping-Hong Zhou 

机构地区：[1]Endoscopy Center,Zhongshan Hospital and Endoscopy Research Institute,Fudan University,180 Fenglin Road,Shanghai 200032,P.R.China [2]Department of Pathology,Zhongshan Hospital,Fudan University,Shanghai 200032,P.R.China

出　　处：《Cancer Communications》2018年第1期42-49,共8页癌症通讯（英文）

基　　金：supported by grants from the National Natural Science Foundation of China(No.81502523);grant from Shanghai Committee of Science and Technology(Nos.17140901100,16DZ2280900,and 14411950505).

摘　　要：Background:Colorectal carcinomas(CRCs)arise from premalignant precursors in an adenoma-carcinoma sequence,in which adenoma with high-grade dysplasia(HGD)and early-stage carcinoma are defined as advanced neoplasia.A limited number of studies have evaluated the long-term outcomes of endoscopic submucosal dissection(ESD)for advanced colorectal neoplasia.This study aimed to assess the efficacy and safety of ESD for advanced colorectal neoplasia as well as the long-term outcomes,including local recurrence and metastasis.Methods:We analyzed data collected from 610 consecutive patients with 616 advanced colorectal neoplasia lesions treated with ESD between January 2007 and December 2013.Clinical,endoscopic,and histological data were col-lected over a median follow-up period of 58 months to determine tumor stage and type,resection status,complica-tions,tumor recurrence,and distant metastasis.Results:The overall rates of en bloc resection,histological complete resection,and major complications were 94.3%,89.4%,and 2.3%,respectively.Hybrid ESD was an independent factor of piecemeal resection.Tumor location in the colon was associated with increased risk of ESD-related complications.During the follow-up period,all patients remained free of metastasis.However,local recurrence occurred in 4 patients(0.8%);piecemeal resection was a risk factor.Conclusions:ESD is effective and safe for resection of advanced colorectal neoplasia,with a high en bloc resection rate and favorable long-term outcomes.ESD is indicated for the treatment of HGD and early-stage CRC to obtain cura-tive resection and reduce local recurrence rate.

关 键 词：Early-stage carcinoma High-grade dysplasia COLORECTUM Endoscopic submucosal resection 

分 类 号：R73[医药卫生—肿瘤]